Still according to Duffet-Smith, a key factor in postpartum depression is exhausted the total exhaustion. Maternal confidence may fade if the mother was not able to handle it and become frustrated because of his physical weakness.

The same thing was also expressed by Ling and Duff (2001), that the symptoms of postpartum depression experienced nearly 60% of women with symptoms of depression in general. But compared with the general depression, postpartum depression has specific characteristics such as:

a. Nightmare. Usually occur during REM sleep. Because dreams – nightmares, individuals were often awakened so that it can cause insomnia.

b. Insomnia. Usually arise as a symptom of another disorder such as anxiety and underlying depression or other emotional disorders that occur in human life.

. Phobia. An irrational fear of some object or situation that can not be eliminated or suppressed by the patient, even though he knows that it is irrational it is. Mothers who gave birth by Caesarean section often feel back and remember the birth she lived. Women who underwent cesarean will feel various emotions. This situation started with a feeling of shock and disbelief over what had happened. Women who have had a Caesarean section to give birth by C-section also for subsequent pregnancies. This can create a fear of needles and equipment operating equipment (Duffet-Smith, 1995).

d. Anxiety. Tension, insecurity and anxiety arising from perceived was going to be unpleasant, but most do not know its source.

e. Increased sensitivity. Postnatal period covers a lot of self-adaptation and habituation. Babies should be taken care of, she should recover from childbirth, she should learn how to care for infants, mothers need to learn to feel satisfied or happy with himself as a mother. Inexperience or lack of confidence by the baby being born, or the time and the extensive demands will increase the sensitivity of the mother (Santrock, 2002).

f. Changes in mood.

ccording Sloane and Bennedict (1997), states that postpartum depression appears with the following symptoms: poor appetite, sad – depressed, feelings of worthlessness, irritability, fatigue, insomnia, anorexia, disturbed by the physical changes, difficulty concentrating, self-injury , anhedonia, self-blame, weakness in the will, has no hope for the future, do not want to deal with other people. On the other hand sometimes vexed and difficult for the mother loves her baby who will not sleep and crying and soiling new fabric replaced. This gives rise to anxiety and feelings of guilt on themselves mothers although rare mother who is really hostile to her baby.

According Nevid et al (1997), postpartum depression is often accompanied by disturbances of appetite and sleep disturbances, low self-esteem and difficulty to maintain concentration or attention.

Specific criteria for the diagnosis of postpartum depression were not included in the DSM-IV, where there are no adequate information to make a specific diagnosis. Diagnosis can be made if the depression occurs in temporal relationship with the birth of a child with the onset of episode within 4 weeks postpartum.

According to the DSM IV, symptoms-symptoms that typically appear on an episode of postpartum among others, changes in mood, mood lability and excessive attitude towards the baby. Women who suffer from postpartum depression often experience great anxiety and often panic.

Although no specific diagnostic criteria in DSM-IV, the characteristics of patients with postpartum depression began to complain of fatigue, mood changes, have episodes of sadness, suspicion and confusion, and do not want to deal with other people. In addition, patients with postpartum depression have a feeling not want to care for her baby, do not love her baby, want to hurt the baby or themselves or both.

Pascasalin depressive symptoms are more mild than pascasalin psychosis. Nevertheless, these abnormalities have the potential to cause trouble or problems for the mother who experienced it (Kruckman in Yanita and Zamralita, 2001).

Based on the above it can be concluded that the symptoms of postpartum depression include trauma to the medical intervention is experienced, fatigue, mood changes, appetite disturbance, sleep disturbance, do not want to deal with other people, do not love her baby, want to hurt the baby or herself alone or both.